This article was co-authored by Janice Litza, MD. Dr. Litza is a Board Certified Family Medicine Physician in Wisconsin. She is a practicing Physician and taught as a Clinical Professor for 13 years, after receiving her MD from the University of Wisconsin-Madison School of Medicine and Public Health in 1998.

There are 14 references cited in this article, which can be found at the bottom of the page.

You've got pain: stomach pain with gas, bloating, and burning, and your doctor thinks it could be due to a Helicobacter pylori infection. H. pylori is a bacteria that lives in the gut, and it's linked to a wide range of health issues, even ulcers and stomach cancer. Treating H. pylori is easy; but first, you have to detect it.[1]XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source

Look for common gastrointestinal symptoms. These can include nausea, excessive burping, bloating, and abdominal pain that worsens on an empty stomach. Together these can be indicators that you might have H. pylori. However, most people don’t experience any symptoms from H. pylori. If you don’t have symptoms, you shouldn’t worry about H. pylori.[2]XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source

Keep in mind that common gastrointestinal symptoms can also indicate dyspepsia, gastritis, or GERD. Your doctor may recommend medication and diet changes first. If you do not get better from these measures, then your doctor may order a test for H. pylori.

Check for any changes in appetite or unusual weight loss. If you haven’t been trying to lose weight and you notice a significant weight loss (5% of your weight in a 6-12 month period), you should contact your doctor in any case. It could be H. pylori, but it could also be quite a few more serious conditions. A severe loss of appetite can also be a significant indicator of something wrong.[3]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source

See a doctor if you have severe symptoms. These can include severe abdominal pain, trouble swallowing, bloody or black stools, or bloody or black vomit. You should see a doctor immediately if you have any of these symptoms. They can help assess what’s wrong and if you do indeed have H. pylori.

If you notice vomit that looks like coffee grounds, then seek immediate medical assistance. This can indicate that there is a severe problem.

Get a blood test. There are blood tests that can show whether you have or have previously had H. pylori. Though they can be a useful diagnostic tool, other tests are typically more accurate for H. pylori. In any case, if you have a blood test, and your doctor thinks you might have or have had H. pylori, she might follow it up with a breath or stool test. You could get the results by the next day.[4]XResearch source

One advantage of the blood test is that its results won't be affected by a recent course of antibiotics.

Get a stool test. If you have this test, you’ll give a stool sample to the lab. They’ll look for H. Pylori antigens. This test is more accurate than the blood test. Pepto-bismol and other drugs can interfere with this test.

Your doctor will provide you with a plastic stool collection container. Make sure you follow all of the instructions accompanying the container.[5]XResearch source

You will need to collect at least 20mm or 5 grams of stool for this test.[6]XResearch source

Keep the stool sample refrigerated if you are going to return to the doctor within 72 hours. If not, freeze it.[7]XResearch source

Get a breath test. In this test you’ll swallow something that has carbon molecules.[8]XTrustworthy SourceCenters for Disease Control and PreventionMain public health institute for the US, run by the Dept. of Health and Human ServicesGo to source This could be a pudding or a pill. You’ll then breath into a bag, and your doctor will check for carbon molecules. Certain drugs such as Pepto-Bismol and antibiotics can interfere with the accuracy of this test. You may have to discontinue taking them a week or so before the test.

You'll first breath into a bag, consume the carbon-containing molecules, and then wait 15 minutes. After that time, you'll be asked to breath into the bag again.[9]XResearch source

Ask your doctor whether you need an endoscopy. An endoscopy is not usually used to diagnose H. pylori, as it is so much more invasive. It is typically used to determine the cause of upper digestive conditions or to diagnose H. pylori ulcers. In any case, unnecessary surgery should be avoided.

Stop eating and drinking 4-8 hours before the procedure. This will ensure you have an empty stomach for the test. It will also help your doctor to see what is going on. Eating before surgery can make complications worse if they develop.[10]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source It is also to prevent pulmonary aspiration.[11]XResearch source

Discontinue certain medications before surgery. You may need to talk to your doctor about specific necessary medications (for diabetes, heart conditions, etc.). However, you should typically stop taking blood thinners. This is to protect you from complications that can occur with medications during surgery.[12]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source

Get someone to drive you home. You will need, as is usually the case, someone to drive you home after surgery. Your judgment will be impaired and you will need someone to help you get home safely. Don’t try to drive home yourself.[13]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source

Wait for results. Ulcer results may be available right after the procedure. But the results for the biopsy looking for H. pylori will likely take a bit longer. Once you have your answer, you can proceed with treatment options.[14]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source

Dr. Litza is a Board Certified Family Medicine Physician in Wisconsin. She is a practicing Physician and taught as a Clinical Professor for 13 years, after receiving her MD from the University of Wisconsin-Madison School of Medicine and Public Health in 1998.

Once you have been confirmed to have H. pylori, the blood test for antibodies will always be positive so you will need to have the stool or even endoscopy with direct biopsy of any areas of concern and retreated, possibly with a different regimen, if the tests are positive again.

About this article

This article was co-authored by Janice Litza, MD. Dr. Litza is a Board Certified Family Medicine Physician in Wisconsin. She is a practicing Physician and taught as a Clinical Professor for 13 years, after receiving her MD from the University of Wisconsin-Madison School of Medicine and Public Health in 1998.

If you think you have Heliobacter Pylori, look for gastrointestinal problems like nausea, excessive burping, bloating, and abdominal pain that feels worse with an empty stomach. Excessive weight loss might also be a sign of Helibacter Pylori, especially if you have not been trying to lose weight. For more serious symptoms, like severe pain, trouble swallowing, bloody or black stool and vomit, see a doctor immediately. Your doctor might perform a blood test to detect Heliobacter Pylori, followed by either a stool or breath test. For more help from our Medical co-author, like how to prepare for an endoscopy, read on.